Effects on bone metabolism in patients with diabetic osteoporosis using alendronate

doi:10.3877/cma.j.issn.2096-0263.2020.06.007

Abstract

Abstract:

Objective

To explore the effect on bone metabolism in patients with diabetic osteoporosis (DOP) using alendronate.

Methods

108 patients with DOP hospitalized in our hospital from December 2017 to December 2018 were randomly divided into the control group (54 cases) and the alendronate group (54 cases). All patients were treated with routine treatment and alendronate group was given alendronate tablets on this basis. After 2 months treatment, the bone metabolism index, bone mineral density (BMD), blood biochemical index and clinical efficacy were observed and compared between the two groups.

Results

After treatment, the serum bone metabolism indexes bone specific alkaline phosphatase (BAP), osteocalcin (BGP) and human tartrate-resistant acid phosphatase 5b (TRAP-5b) in the control group were (7.52±3.20) μg/L, (6.24±2.22) U/L, (3.30±1.13) ng/ml, respectively, and the alendronate group was (9.41±3.32) μg/L, (7.73±2.34) U/L, (2.45±1.18) ng/ml, respectively. After treatment, the levels of BAP (t=4.670, P<0.05) and BGP (t=6.120, P<0.05) in the two groups were higher than those before treatment. Compared with the control group, the levels of sodium alendronate group were significantly higher than those in the control group, with statistically significant differences (t=3.010 and 3.390, P<0.01, respectively). Trap-5b (t= 4.780 and 5.620, P<0.05, respectively) level of the two groups decreased compared with that before treatment. Compared with the control group, sodium alendronate group was significantly lower than the control group, and the difference was statistically significant (t=3.820, P<0.01). There was no significant difference in bone metabolism before and after treatment in the control group (P>0.05). After treatment, the BMD of lumbar spine and femoral neck in the control group were (0.82±0.06) g/cm² and (0.74±0.05) g/cm², respectively, and those in the alenphosphate group were (0.91±0.04) g/cm² and (0.83±0.08) g/cm², respectively. BMD levels in lumbar spine and femoral neck (t=3.840 and 3.760, P<0.05, respectively) were higher in both groups than before treatment, and the alendronate group was higher than the control group (t=9.170 and 7.010, P<0.05, respectively). After treatment, fasting blood glucose (FBG), postprandial blood glucose (2 hBG), glycadified hemoglobin (HbA1c) levels in the control group were (7.06±0.29) mmol/L, (8.02±3.17) mmol/L, (6.21±0.46)%, respectively. The FBG, 2 hBG, and HbA1c levels in the control group were (8.12±0.33) mmol/L, (9.98±0.54) mmol/L, and (7.56±0.67)%, respectively. The comparison between the two groups showed that the alenophosphate group was significantly lower than the control group, with statistically significant differences (t=17.730, 4.480, 12.210, P<0.01). The total effective rate was 90.74% significantly higher than 79.63% in the control group (P<0.05).

Conclusion

Alendronate combined with control was effective in the treatment of patients with DOP, and it can improve bone metabolism and increase the level of BMD, which was worthy of clinical promotion and application.

Key words: Sodium alendrite, Diabetes, Osteoporosis, Bone metabolism, Bone mineral density

Li Yang, Qiang Li, Zhiyun Kan, Haisheng Hou. Effects on bone metabolism in patients with diabetic osteoporosis using alendronate[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2020, 06(06): 351-356.

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References 22

1	Yoo TK, Kim SH, Kwak J, et al. Association between osteoporosis and Age-Related macular degeneration: the Korea National health and nutrition examination survey [J]. Invest Ophthalmol Vis Sci, 2018, 59(4): AMD132-AMD142.
2	Lei C, Xueming H, Ruihang D. MLN64 deletion suppresses RANKL-induced osteoclastic differentiation and attenuates diabetic osteoporosis in streptozotocin (STZ)-induced mice [J]. Biochem Biophys Res Commun, 2018, 505(4): 1228-1235.
3	刘丹丹,常虹,谈敏.男性2型糖尿病患者25羟维生素D3及骨代谢指标的变化分析[J].安徽医药,2015,19(2): 288-291.
4	蔡德,林志绣,黄志华,等.阿仑磷酸钠联合金天格胶囊治疗绝经后骨质疏松临床观察[J].中国药师,2015,18(8): 1352-1354.
5	姚新苗,史晓林,王健,等.浙江省中医药防治原发性骨质疏松症分级诊疗专家共识(2017)[J].浙江中医杂志,2018,53(4): 237-241.
6	廖涌.中国糖尿病的流行病学现状及展望[J].重庆医科大学学报,2015,40(7): 1042-1045.
7	郑博,蒋涛,黄佳涌,等.我国中老年脆性髋部骨折及桡骨远端骨折骨质疏松诊断标准与WHO诊断标准的比较分析[J].中国骨质疏松杂志,2018,24(10): 1299-1304.
8	赵彦杰,何兰杰.2型糖尿病骨质疏松、胰岛素抵抗与维生素D水平的相关性[J].宁夏医学杂志,2015,37(3): 256-258.
9	刘爽,杨梅.糖尿病骨质疏松症发病机制探讨[J].实用糖尿病杂志,2014,10(6): 59-60.
10	王芳,任汉强,沈晓波.胰岛素联合阿仑膦酸钠对老年糖尿病骨质疏松症患者骨密度及血清BAP、TRAP-5b、BGP水平影响[J].海南医学院学报,2016,22(13): 1387-1389+1393.
11	陈华.阿仑膦酸钠联合碳酸钙D_3片治疗2型糖尿病性骨质疏松症疗效观察[J].药物流行病学杂志,2015,24(8): 451-453+459.
12	王玉容,方向明,叶文春,等.唑来膦酸注射液治疗糖尿病骨质疏松患者的疗效研究[J].四川医学,2015,36(1): 69-71.
13	陈玉凤,郭献山,赵建林,等.老年2型糖尿病中性粒细胞/淋巴细胞比率与骨质疏松症的关系[J].中国骨质疏松杂志,2015,21(7): 824-826.
14	Fuglsang-Nielsen R, Starup-Linde J, Gregersen S, et al. The effect of meals on bone turnover - a systematic review with focus on diabetic bone disease [J]. Expert Rev Endocrinol Metab, 2018, 13(5):233-249.
15	丛宝华,赵方,宋飞,等.胰岛素联合阿仑膦酸钠对2型糖尿病骨质疏松症患者骨代谢的影响[J].现代生物医学进展,2017,17(3): 516-519.
16	屈强,蔺改雯,金晶.阿仑磷酸钠与阿法骨化醇胶丸联合用药治疗绝经后骨质疏松症疗效观察[J].陕西医学杂志,2015,44(7): 906-908.
17	朱超,刘伟,王华,等.阿仑磷酸钠联合阿法骨化醇治疗老年肱骨近端骨折的效果[J].中国医药导报,2016,13(24): 85-88+104.
18	张志梅,张倩辉,李彩英,等.利拉鲁肽联合胰岛素治疗2型糖尿病骨质疏松的疗效[J].西北药学杂志,2018,33(6): 830-833.
19	王兵,杨勋能.2型糖尿病合并骨质疏松患者DEXA骨密度测量结果与血清细胞因子、胰岛素抵抗的关系[J].海南医学院学报,2017,23(2): 277-280.
20	刘君英,阎德文,邓建新,等.围绝经期2型糖尿病骨质疏松症治疗中胰岛素与阿仑膦酸钠的联合应用效果观察[J].山东医药,2017,57(19): 69-71.
21	周庆胜.骨化三醇联合阿仑磷酸钠治疗绝经后骨质疏松症的疗效研究[J].实用妇科内分泌杂志:电子版,2017,4(20): 109+111.
22	赵春芝,娄方勇.胰岛素、阿仑膦酸钠治疗新诊断老年糖尿病骨质疏松症患者骨密度及骨转换指标的研究[J].中国骨质疏松杂志,2014,20(4): 392-395,438.

组别	性别（例，男/女）	年龄（岁， ±s）	骨质疏松分级（轻度/中度/重度）
阿仑磷酸钠组	34/20	54±8	15/23/16
对照组	31/23	53±8	14/22/18
统计值	χ²=1.453	t=2.561	χ²=1.562
P值	0.072	0.057	0.069

组别	性别（例，男/女）	年龄（岁， ±s）	骨质疏松分级（轻度/中度/重度）
阿仑磷酸钠组	34/20	54±8	15/23/16
对照组	31/23	53±8	14/22/18
统计值	χ²=1.453	t=2.561	χ²=1.562
P值	0.072	0.057	0.069

组别	例数	治疗前			治疗后2个月
组别	例数	BAP（μg/L）	TRAP-5b（ng/ml）	BGP（U/L）	BAP（μg/L）	TRAP-5b（ng/ml）	BGP（U/L）
阿仑磷酸钠组	54	7.47±3.19	3.32±1.16	6.23±2.23	9.41±3.32^a	2.45±1.18^a	7.73±2.34^a
对照组	54	7.49±3.31	3.33±1.17	6.22±2.24	7.52±3.20^a	3.30±1.13^a	6.24±2.22^a
t值		0.030	0.040	0.020	3.010	3.820	3.390
P值		>0.05	>0.05	>0.05	<0.01	<0.01	<0.01

组别	例数	治疗前			治疗后2个月
组别	例数	BAP（μg/L）	TRAP-5b（ng/ml）	BGP（U/L）	BAP（μg/L）	TRAP-5b（ng/ml）	BGP（U/L）
阿仑磷酸钠组	54	7.47±3.19	3.32±1.16	6.23±2.23	9.41±3.32^a	2.45±1.18^a	7.73±2.34^a
对照组	54	7.49±3.31	3.33±1.17	6.22±2.24	7.52±3.20^a	3.30±1.13^a	6.24±2.22^a
t值		0.030	0.040	0.020	3.010	3.820	3.390
P值		>0.05	>0.05	>0.05	<0.01	<0.01	<0.01

组别	例数	治疗前		治疗后2个月
组别	例数	腰椎	股骨颈	腰椎	股骨颈
阿仑磷酸钠组	54	0.75±0.09	0.66±0.08	0.91±0.04^a	0.83±0.08^a
对照组	54	0.74±0.07	0.68±0.07	0.82±0.06^a	0.74±0.05^a
t值		0.640	1.380	9.170	7.010
P值		>0.05	>0.05	<0.01	<0.01

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